Mohsenabadi Hamid, Pirmoradi Mohammadreza, Zahedi Tajrishi Komeil, Gharraee Banafsheh
Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
Front Psychiatry. 2025 Feb 5;16:1478442. doi: 10.3389/fpsyt.2025.1478442. eCollection 2025.
Emotion regulation (ER) and distress tolerance (DT) are considered transdiagnostic risk factors for a range of anxiety disorders. This study investigated the relationship between anxiety sensitivity (AS) and health anxiety (HA) in the general population, focusing on the mediating roles of DT and ER.
The study was conducted as a cross-sectional survey from October to December 2023 in Tehran Province, Iran. A total of 971 individuals participated in this study (52.8% female; mean age 39.04 years, SD=10.64). Participants completed self-report questionnaires to assess HA (The Short Health Anxiety Inventory), AS (The Anxiety Sensitivity Index-3), DT (The 15-item Distress Tolerance Scale) and ER (The 10-item Emotion Regulation Questionnaire). We used structural equation modeling (SEM) to examine the hypothesis that DT and ER would mediate the relationship between AS and the HA.
AS was modestly related to all measures (r from -0.40 to 0.55). According to the SEM analysis, AS (β = 0.45, 95%CI [0.34, 0.56]) had a significant direct effect on HA. However, the analysis of the indirect effects revealed that both DT (β = 0.10, 95% CI [0.06, 0.16]) and emotion regulation strategies-cognitive reappraisal (β = 0.06, 95% CI [0.01, 0.11]) and expressive suppression (β = 0.11, 95% CI [0.06, 0.18])-act as partial mediators in the relationship between AS and HA.
AS plays a crucial role in predisposing individuals to HA. The mediating roles of DT and ER provide insight into the link between AS and HA. Nevertheless, the study's cross-sectional design and reliance on a non-clinical sample limit the applicability of the results. Further research involving different samples and intervention studies is needed to validate and expand upon these findings.
情绪调节（ER）和痛苦耐受（DT）被认为是一系列焦虑症的跨诊断风险因素。本研究调查了普通人群中焦虑敏感性（AS）与健康焦虑（HA）之间的关系，重点关注DT和ER的中介作用。
该研究于2023年10月至12月在伊朗德黑兰省进行横断面调查。共有971人参与本研究（女性占52.8%；平均年龄39.04岁，标准差=10.64）。参与者完成了自我报告问卷，以评估HA（简短健康焦虑量表）、AS（焦虑敏感性指数-3）、DT（15项痛苦耐受量表）和ER（10项情绪调节问卷）。我们使用结构方程模型（SEM）来检验DT和ER将介导AS与HA之间关系的假设。
AS与所有测量指标均呈中等程度相关（r值在-0.40至0.55之间）。根据SEM分析，AS（β = 0.45，95%置信区间[0.34，0.56]）对HA有显著直接效应。然而，间接效应分析表明，DT（β = 0.10，95%置信区间[0.06，0.16]）以及情绪调节策略——认知重评（β = 0.06，95%置信区间[0.01，0.11]）和表达抑制（β = 0.11，95%置信区间[0.06，0.18]）在AS与HA之间的关系中均起部分中介作用。
AS在使个体易患HA方面起着关键作用。DT和ER的中介作用为AS与HA之间的联系提供了见解。然而，该研究的横断面设计以及对非临床样本的依赖限制了结果的适用性。需要进一步开展涉及不同样本的研究和干预研究来验证和扩展这些发现。
